Pain
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Changes in thermal sensibility for warmth, cold, heat pain and cold pain during nerve compression block of impulse conduction in myelinated fibres were studied in 20 healthy subjects. When mainly unmyelinated fibres were conducting, after 30-36 min of nerve compression, the pain threshold, induced by cold stimulation, was shifted towards higher temperatures (from 19.1 degrees C to 22.8 degrees C, mean values). Furthermore, the sensation of cold pain became more unpleasant and had a hot burning rather than a cold quality. ⋯ Whereas dramatic changes in the sensation of cold pain were observed during the course of nerve compression, no alteration in heat pain threshold was seen. This implies that heat pain threshold in hairy skin is due to activation of C nociceptor fibres without any significant contribution from myelinated nociceptor fibres. Furthermore, no gating from heat-sensitive myelinated fibre input was evident on heat pain threshold.
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A modified formalin test in mice was investigated. The pain response curve induced by 0.5% formalin was biphasic, having 2 peaks, from 0 to 5 min (first phase) and from 15 to 20 min (second phase). A low concentration of formalin was used, allowing the effects of weak analgesics to be detected. ⋯ The second phase was inhibited by compound 48/80 pretreatment, indomethacin and bradykinin inhibitor. Therefore, it is suggested that substance P and bradykinin participate in the manifestation of the first phase response, and histamine, serotonin, prostaglandin and bradykinin are involved in the second phase. These results indicate that the first and second phase responses induced by formalin have distinct characteristic properties, and it is a very useful method for examining pain, nociception and its modulation by pharmacological or other means.
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We report the results of a single session, non-blinded, trial of topical application of 10% lidocaine in gel form to the painful skin of 11 patients with well established post-herpetic neuralgia (PHN). Pain decreased as measured by 100 mm VAS pain scale and 100 mm VAS pain relief scale in both trigeminal and thoracic PHN patients.